1. Field of the Invention
The present invention is directed to an adjustable multi-component orthosis to provide an adjustable body support portion for conforming to a patient's body configuration such as a low profile hip orthosis for post-surgery treatment of a patient who has had a hip arthroscopy procedure.
2. Description of Related Art
An orthosis which can conform to a particular body configuration has required a customized orthosis made from body measurements of a patient. However, medical and insurance costs have significantly increased and the provisions of pre-manufactured orthosis that can be adjusted by an orthotist shave become more popular.
An example is an orthotic to provide support for the body after replacement of a hip joint or hip arthroplasty, which is a surgical procedure in which a hip joint is replaced by a prosthetic implant. A femoral component can be replaced with a metallic or ceramic artificial femoral head where ceramic bearing surfaces are frequently employed to address any wear issue and relieve possible problems from osteolysis that can occur from acrylic bone cement and wear debris.
Risks that are involved in the surgery are a potential for blood clots in the legs, infections, and nerve damage. Generally it is desirable to have the patient start moving and walking as soon as possible to prevent complications. Postoperative hip orthoses have been known to reduce the incidences of dislocation in both patients who have undergone a primary hip replacement and also patients that have required a subsequent hip revision. Reference can be made to a clinical report, Orthotic Management of Hip Dislocation using a Newport™ hip orthosis by Dulcey Lima.
Orthopedic hip configurations have been utilized for various purposes such as a leg abductor to resist muscular contractions as shown in U.S. Pat. No. 5,814,001. U.S. Pat. No. 6,589,195, U.S. Pat. No. 7,048,707 are examples of hip orthoses for permitting an orthotic management when the hip joint has been compromised with the capability of controlling flexion and extension internal and external rotation adduction and abduction. In such an environment, the hip joint is a synovial ball and socket joint that generally consists of an articulation of the spherical head of the femur with a cup like shape of the acetabulum. The acetabular labrum attaches to a bony rim of the acetabulum and cups around the head of the femur to hold it firmly in place. Various ligaments add strength to the articulation of the hip joint and a large number of muscles act on the hip joint. The gluteus medius is primarily associated with abduction. The anterior fibers assist with flexion and internal rotation. Posterior fibers assist with the extension and external rotation. These respective muscle groups stabilize the pelvis during a single leg support.
However, these muscle groups can be compromised when surgical procedures are performed at the hip joint such as a hip replacement surgery. A significant problem that occurs when a hip joint has been compromised is the possibility of subsequent dislocation of the hip joint. Thus, the femoral head can be driven out of the acetabulum. For example, the hip can be most susceptible to posterior dislocation when it is flexed past 90°, internally rotated and abducted. These movements can occur in everyday life, such as by sitting on a low chair and leaning forward while putting weight on an affected hip joint and internally rotating when coming to a standing position. Thus, common activities of daily living, specifically excessive hip flexion with loaded extremity and internal rotation on the affected side can cause dislocation. Anterior dislocation can also occur when a hip is externally rotated, abducted and flexed. For example, if there is an external force such as the knee being hit or subject to an accidental contact with an object, the neck of the femur or the greater trochanter levers the femur out of the acetabulum. Thus, an orthosis must be able to effectively control the limits of extension rotation in a patient who has experienced an anterior dislocation.
Additionally, as the population becomes older, there are more occasions for the treatment of hip disorders and there is still a need to improve the function of such orthoses and their component parts in the medical field in an economical manner while addressing a comfort level for the patient to encourage maximum prolonged usage.
Efforts have also been made to encourage early mobility of a patient after a hip surgery and it is desirable to enable the patient to easily don a hip orthosis with appropriate compression with a lightweight structure. It is still necessary for the hip orthosis to provide adequate rigidity to stabilize the hip with preferably a configuration that would encourage prolonged use by the patient. U.S. Pat. No. 7,473,235 is an example of a lightweight prophylactic hip orthosis. U.S. Pat. No. 7,597,672 discloses a hip orthosis with a rotable leaf spring for the user to actuate after donning the hip orthosis.
Orthopedic surgeons have now developed new techniques for repairing the hip joint that can often provide pain relief and postpone or eliminate the need for total joint replacement. This procedure, hip arthroscopy, utilizes an extremely small and long camera called an arthroscope that allows the surgeon to visualize the inside of the joint without the need for an open surgical procedure. Traction is applied to the foot to distract the hip joint so that sufficient space can be created between the hip joint surfaces to insert specialized instruments. Arthroscopy uses a variety of “shavers” used to debride the frayed labrum or cartilage, and uses specialized tools to reconnect and repair soft tissue, and incorporates fluoroscopy to determine the precise location of the surgical instruments. Fluid is inserted through the hip joint to both clear debris and improve visualization for the surgeon. Hip arthroscopy is a less invasive procedure with significantly less soft tissue trauma than the traditional open surgical procedures such as total hip replacement (arthroplasty).
Hip arthroscopy can treat labral tears in the labrum cuff of thick tissue that surrounds and supports the hip joint. Additionally, if pieces of cartilage form within the hip joint they can be removed by lavage and rough edges in the hip joint can be scraped and smoothed. Additionally, the synovial lining of the hip joint can be addressed if inflamed.
While a hip arthroscopy procedure can frequently be performed as an outpatient procedure without spending days in a hospital, it is still necessary to rehabilitate the muscles around the joint to make them stronger to assist the weight-bearing surfaces within the hip joint and increase the range of motion of the hip joint. The proper use of exercise in the recovery process encourages healing and failure to exercise and move on the hip joint can even lead to permanent disability.
There is still a need in the medical industry to provide a relatively lightweight and multi-component low profile orthosis that can be easily adjusted to meet the needs of the patient, for example in the post treatment of hip arthroscopy patients that can be readily adjustable by the orthotist for the particular patient while being lightweight and of a low profile to encourage prolonged use by the patient and effectively protect any compromised hip joint.